Question

In assessing an older female client with complication associated with chronic obstructive pulmonary disease (COPD), the nurse notices a change in the client's appearance. Her face appears tense and she begs the nurse not to leave her alone. Her pulse rate is 100, and respirations are 26 per min. What is the primary nursing diagnosis?

Answer 1

The primary nursing diagnosis is Anxiety, due to the patient's appearance, elevated pulse rate, and increased respiratory rate, which are indicative of discomfort and fear associated with the difficulty in breathing and complications of COPD.

Step-by-step explanation:

The primary nursing diagnosis for an older female client with complications associated with chronic obstructive pulmonary disease (COPD) who appears tense, begs the nurse not to leave her alone, has a pulse rate of 100, and respirations are 26 per min, would likely be Anxiety related to difficulty breathing and fear of suffocation, as evidenced by changes in her appearance and vital signs.

Factors Contributing to the Diagnosis

Patients with COPD often experience anxiety due to hypoxemia because lower levels of oxygen can lead to an increased heart rate (tachycardia) and increased respiratory rate (tachypnea), as is seen in this patient. The patient's subjective experience of wanting the nurse to remain nearby can further indicate feelings of fear and anxiety.

The presentation resembles that of a patient with pneumonia, who can also show signs such as an elevated heart rate, hypoxemia, and possible production of phlegm, but the diagnosis of anxiety is more directly related to the patient's expressed fear and physiological response to distress.